Provider Demographics
NPI:1881885325
Name:HEALY, MARTIN JAMES JR (DMD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:JAMES
Last Name:HEALY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2309
Mailing Address - Country:US
Mailing Address - Phone:914-946-2122
Mailing Address - Fax:914-946-5251
Practice Address - Street 1:2 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2309
Practice Address - Country:US
Practice Address - Phone:914-946-2122
Practice Address - Fax:914-946-5251
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0314451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice